非奈利酮在难治性高血压中的应用现状

张平

doi:10.2095-3593.2026.050007

中国药物评价 >

2026 , Vol. 43 >Issue 3: 205 - 205-209

DOI: https://doi.org/10.2095-3593.2026.050007

临床研究

非奈利酮在难治性高血压中的应用现状

张平

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贵州健康职业学院基础医学部，贵州铜仁 554300

张平，男，硕士，讲师，研究方向：心血管疾病

收稿日期: 2026-01-13

修回日期: 2026-03-24

录用日期: 2026-05-19

网络出版日期: 2026-08-12

基金资助

铜仁市科技计划项目（铜市科研〔2025〕76号）；贵州健康职业学院2024年院级科研创新团队项目（贵健院发〔2024〕66号）

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Application Status of Finerenone in Resistant Hypertension

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Department of Basic Medicine， Guizhou Health Vocational College， Guizhou Tongren 554300， China

Received date: 2026-01-13

Revised date: 2026-03-24

Accepted date: 2026-05-19

Online published: 2026-08-12

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摘要

非奈利酮为第三代非甾体类盐皮质激素受体拮抗剂，与前两代甾体类盐皮质激素受体拮抗剂相比，具有更高的受体选择性和较低的高钾血症及性激素相关不良反应的发生风险，具有降压、抗炎、抗氧化应激、改善胰岛素抵抗、抗心肌纤维化、改善心室重构及心功能等多重心血管保护作用。对于合并2型糖尿病或慢性肾脏病的难治性高血压患者，非奈利酮不仅降压疗效确切、安全性良好，还能带来显著的心肾保护获益。其治疗原发性醛固酮增多症的降压效果与螺内酯相当，且药物不良反应的发生率更低。其与钠-葡萄糖协同转运蛋白2抑制剂或雷公藤多苷联合应用时，对糖尿病肾病的肾脏保护效果更佳，且不会增加不良反应的发生风险。现就非奈利酮在难治性高血压中的临床研究作一综述，以期为非奈利酮在难治性高血压的临床应用提供参考。

关键词： ; font-size:medium; ">非奈利酮；难治性高血压；盐皮质激素受体拮抗剂

本文引用格式

张平 . 非奈利酮在难治性高血压中的应用现状[J]. 中国药物评价, 2026 , 43(3) : 205 -205-209 . DOI: 10.2095-3593.2026.050007

Abstract

Finerenone is a third-generation non-steroid mineralocorticoid receptor antagonist (MRA). Compared with the first two generations of steroidal MRAs， it has higher receptor selectivity and a lower risk of hyperkalemia and sex hormone-related adverse reactions. It possesses multiple cardiovascular protective effects， including lowering blood pressure， anti-inflammatory， antioxidant stress， anti-myocardial fibrosis improving insulin resistance， ventricular remodeling and cardiac function. For patients with resistant hypertension complicated by type 2 diabetes mellitus or chronic kidney disease， finerenone not only exhibits a definite antihypertensive effect and good safety profile， but also brings significant cardiorenal protection benefits. Its antihypertensive effect in treating primary aldosteronism is comparable to that of spironolactone， and the incidence of adverse drug reactions is lower. When used in combination with sodium-glucose co-transporter 2 inhibitors or tripterygium glycosides， it exhibits better renal protective effects on diabetic nephropathy without increasing the risk of adverse reactions. This article reviews the clinical research on finerenone for resistant hypertension， in order to provide a reference for its clinical application.

Key words： ; font-size:medium; ">Finerenone； Resistant hypertension； Mineralocorticoid receptor antagonist

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